MEDICARE: CAPE CHIROPRACTIC GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	Y40145	OTHER	MA	BCBS MA
3	686094	OTHER	MA	TUFTS HEALTH PLAN

General Provider Information

NPI Number	:	1427227594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPE CHIROPRACTIC GROUP LLC

Provider Business Mailing Address
First Line	:	1665 FALMOUTH RD
Second Line	:
City	:	CENTERVILLE
State	:	MA
Zip	:	02632-2944
Country	:	US
Telephone Number	:	508-778-5005
Fax Number	:	508-778-5006

Provider Business Practice Location Address
First Line	:	1665 FALMOUTH RD
Second Line	:
City	:	CENTERVILLE
State	:	MA
Zip	:	02632-2944
Country	:	US
Telephone Number	:	508-778-5005
Fax Number	:	508-778-5006

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRIAN V AVITABILE
Credential	:	DC
Telephone Number	:	508-778-5005

Provider Enumeration Date	:	02/22/2008
Last Update Date	:	01/18/2019

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Directions to “CAPE CHIROPRACTIC GROUP LLC ” Practice Location

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